The loss of a loved one is always difficult. Whether a loss is sudden or expected, coping in the aftermath can feel impossible. Loss can bring about many complex feelings, and over the years, experts have worked to understand the stages of grief and how people move through the grieving process.
The Five Stages of Grief
Psychiatrist Elisabeth Kubler-Ross outlined a theory of five distinct stages of grief that people go through after a loss:[1]
- Denial – the first stage of grief, denial helps people protect themselves from the pain of their loss. It can be incredibly difficult to accept that someone has died, and there is a lot of painful information to process. Denial is a common defence mechanism that provides a buffer to the shock and pain of the situation, helping people to process their loss in their own time.
- Anger – after denial comes anger. The extreme emotional discomfort and pain of processing a loss is redirected and expressed as anger, and people may feel angry at everyone and everything as they process their feelings.
- Bargaining – bargaining helps people hold onto hope as they grieve. Quite often an if/then scenario, this stage is often accompanied by guilt, as people think about how they could have done things differently and wish they could go back in time to change things.
- Depression – an intense sadness accompanies this fourth stage of grief as people face the reality of their loss. They can feel fatigued, may withdraw from their loved ones, and lose interest in things that once brought them joy. Depression experienced while grieving is not necessarily a permanent mental health condition but rather a response to the grieving process.
- Acceptance – acceptance is the final stage. Acceptance does not mean that it is any less painful or that people will never feel sad or angry anymore. Instead, they come to terms and start to move on with their lives.
There is no timeline for people to accept their loss, and this is not a comprehensive list. Many other emotions may arise during the grieving process, including detachment, resentment, and even relief, especially if they have watched a loved one suffer from a long illness.
Different Stages of Grief
There are many interpretations of the stages of grief. For example, psychiatrist Colin Murray Parkes developed a model of grief based on attachment theory which outlined four phases instead of five:[2]
- Shock and numbness – closely related to the denial stage in Kubler-Ross’s theory; this is the first stage of Parke’s theory. In this stage, people feel overwhelmed when coping with their loss and may feel physical distress leading to somatic symptoms.
- Searching and yearning – people begin to search for comfort and become preoccupied with the person they have lost.
- Despair and disorganisation – in this phase, people may become angry and upset, finally realising that their loved one is gone.
- Reorganisation and recovery – similar to the acceptance stage, in this phase, people begin to come to terms with their loss. The sadness and longing may not disappear, but people start to move towards healing.
As with the five stages of grief, there is no timeline to move through each phase; the processing of emotions is a very personal experience.
Traumatic Grief
Traumatic grief can occur in response to a sudden, unexpected, or violent death of a loved one. The shock of the situation can be intensely traumatic and cause conditions such as prolonged grief disorder and complicated grief disorder.
For those who have experienced traumatic grief, their recovery process may not fit into specific stages, or they may get stuck in one stage. The symptoms of traumatic grief can include:
- Emotional numbness
- Difficulty sleeping
- Increased anxiety
- Loss of appetite
- Trembling and shaking
Traumatic grief symptoms are often more intense and persistent than regular grief.
Coping with Grief
There is no one way to cope after losing a loved one. The grieving process is non-linear, and people may experience different aspects at different times.
There are several ways to help people come to terms with their loss, such as:
- Return to a hobby – having a hobby such as crochet, painting, or gardening can give people an outlet for their emotions and provide them with something else to focus on.
- Reach out to family and friends – speaking with loved ones can help process emotions and help people feel connected to others who can relate to what they are going through.
- Practice self-care – the mind and body are connected. Eating a balanced diet, staying hydrated, and exercising regularly can boost your mental and physical health and can also help combat stress and fatigue.
- Note down grief triggers – birthdays, anniversaries, and holidays can bring difficult feelings to the surface, no matter how long it has been since a loss. By knowing what might be a trigger, people can plan what they want to do, whether that is spending the day with a friend, honouring their loss, or simply sitting with their emotions.
Even with the best efforts, grief can be intensely challenging to manage and can get in the way of daily life. If you find that you are unable to move past your grief, professional treatment may be helpful.
If you have a client or know of someone struggling with grief and loss, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential programme and outpatient therapies addressing trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).
Sources:
[1] Newman L. Elisabeth Kübler-Ross. BMJ. 2004;329(7466):627.
[2] Parkes CM. Bereavement in adult life. BMJ. 1998;316(7134):856–859. doi:10.1136/bmj.316.7134.856